Healthcare Provider Details

I. General information

NPI: 1902939721
Provider Name (Legal Business Name): SHARP HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 11/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9610 GRANITE RIDGE DR STE C
SAN DIEGO CA
92123-2684
US

IV. Provider business mailing address

8695 SPECTRUM CENTER BLVD
SAN DIEGO CA
92123-1489
US

V. Phone/Fax

Practice location:
  • Phone: 858-499-3025
  • Fax:
Mailing address:
  • Phone: 858-499-3025
  • Fax: 858-499-3020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER D. HOWARD
Title or Position: PRESIDENT & CEO SHARP HEALTHCARE
Credential:
Phone: 858-499-4003